What is Cirrhosis?
Cirrhosis is a complication of many liver diseases characterized by abnormal structure and function of the liver. The diseases that lead to cirrhosis do so because they injure and kill liver cells, after which the inflammation and repair that is associated with the dying liver cells causes scar tissue to form. The liver cells that do not die multiply in an attempt to replace the cells that have died. This results in clusters of newly formed liver cells (regenerative nodules) within the scar tissue.
What is Liver Cirrhosis ?
The second largest body organ is the liver that carries out important functions such as making vital nutrients, cleaning of the blood and detoxifying harmful substances in the body. The formation of the scar tissue blocks the blood flow through the organ and harms the liver structure. Due to these reasons, there is slow processing of hormones, toxins, nutrients, drugs, proteins along with other substances that are created by the liver. The functions of the liver include –
- It produces cholesterol and breaks down saturated fat.
- It produces cholesterol and breaks down saturated fat.
- It manufactures the substance bile that helps in digestion of the food.
- It manufactures many blood proteins that help in immune system function, clotting and oxygen transport.
- It helps in getting rid of many harmful substances in the bloodstream that include alcohol and drugs.
- It also stores excess nutrients and also returns some of the nutrients to the bloodstream.
Causes of Liver Cirrhosis
The most common causes of this condition include alcohol abuse, Hepatitis and fatty liver. However, any damage caused to the liver results in the condition of cirrhosis such as –
- Frequent and repeated attacks of heart failure with fluid backing up into the liver.
- Fatty liver linked with diabetes and obesity.
- Severe liver viral infections
- Blockage of the bile duct.
It also includes some inherited diseases –
- Alpha 1 Antitrypsin deficiency (an absence of specific enzyme in the liver).
- Hemochromatosis is the condition due to abnormal liver function.
- Cystic Fibrosis
- Wilson’s disease (abnormal storage of copper in the liver).
- Glycogen storage diseases (when the body is unable to produce glycogen).
Symptoms of Cirrhosis Peolple with cirrhosis may have few or no symptoms and signs of liver disease. Some of the symptoms may be nonspecific and don't suggest the liver is their cause. Common symptoms and signs of cirrhosis include:
- Yellowing of the skin (jaundice) due to the accumulation of bilirubin in the blood
- Easy bruising from decreased production of blood clotting factors by the diseased liver.
- Weakness,Loss of appetite
Advanced Symptoms Include
- Gastrointestinal bleeding
- Impaired sleep
- Poor memory
- Decreased muscle mass and weakness
- Difficulty in concentrating
- Accumulation of fluid in the abdomen or in legs
Diagnosis and Evaluation of Cirrhosis
Biopsy of the liver is the best test for diagnosing the condition of cirrhosis. Liver biopsy is meant for those patients in whom the presence of the condition of cirrhosis is not clear. The other tests include physical examination, history evaluation and routine testing. Some other tests may also be done for diagnosing the underlying disease which is resulting in the condition of cirrhosis.
Stages of Cirrhosis
- Stage 1: During the initial stage of cirrhosis, a patient may face a few symptoms that include dry mouth, enlargement of the upper stomach area, jaundice and fatigue. The problem of itching can also be seen in some patients. Cirrhosis in its initial stages can be easily eliminated.
- Stage 2: In the absence of appropriate medical care there can be a progression of stage 2. Now the abnormal tissues that were created in stage 1 are now transformed into rigid bands of connective tissue. Fibrosis is the procedure where there is a transformation of tissues. Both fibrosis and the inflammation spread in the periportal and portal veins of the patient.
- Stage 3: Now in this stage, the rigid band of connective tissue merges with each other. There is immense enlargement due to the process of merging. This enlargement hampers the functions of the liver. The liver is unable to digest fat contents, cannot store nutrients or support the blood streaming. Heart problems and kidney problems are due to the condition of cirrhosis.
- Stage 4: This is considered as the most dangerous stage of cirrhosis. The surgery of liver transplant can be opted at this last stage. The liver performs normally after the liver transplant surgery.
Treatment for Cirrhosis
Following are the treatments for the cirrhosis condition –
- Liver transplantation
- Preventing further damage to the liver
- Detecting liver cancer early or preventing it
- Treating the complications of cirrhosis.
In order to control the symptoms of cirrhosis, certain medications can also be given. By decreasing salt in the diet, ascites and edema can be treated. Diuretics is the drug which can prevent edema from occurring again and also removes excess fluid. Changed mental function due to cirrhosis can be treated with the help of drug and diet therapies.
Also referred to as malignant hepatoma, hepatocellular carcinoma is a type of liver cancer. Following are the different conditions that can increase the chances of Hepatocellular Carcinoma –
- Wilson’s disease
- Hepatitis B
- Cirrhosis of the liver
- Aflatoxin consumption
- Hepatitis C
Secondary Biliary Cirrhosis
When the bile duct is not able to transfer the bile effectively as a result of secondary cause that leads to blockage, scarring or inflammation is termed as Secondary Biliary Cirrhosis. This condition could result from cystic fibrosis, a congenital defect of the bile ducts or gallstones. Other causes include –
- Idiopathic sclerosing cholangitis
- Chronic pancreatitis
- Cystic fibrosis
- Congenital biliary atresia
- Bile duct narrowing after gallbladder surgery